A Congressional Budget Office analysis projects that changing temperatures could prevent about 2.5 million deaths among Medicare beneficiaries through 2075 as fewer dangerous cold days offset increased heat exposure, while emergency department visits rise but related spending declines.
By yourNEWS Media Newsroom.
WASHINGTON — A warmer climate could result in fewer temperature-related deaths among older Americans over the next several decades, with the decline largely driven by fewer dangerous cold days and increased adaptation to heat, according to a new Congressional Budget Office analysis.
The CBO analysis, published in September, estimates that changing temperatures will prevent approximately 2.5 million deaths among Medicare beneficiaries from 2030 through 2075.
Read the Full Report: 62555-Temperatures-Medicare
Researchers used emergency department data from 2015 through 2019 as a baseline and modeled how future temperature changes could affect emergency care, mortality and Medicare spending.
The projections indicate that warmer temperatures would not affect every part of the country in the same way. Instead, the effects depend substantially on regional climate, because residents of different areas are accustomed to different temperature ranges.
In warmer parts of the United States, unusually cold days currently produce some of the largest increases in emergency department visits and deaths among Medicare beneficiaries. As those days become less common, CBO projects that temperature-related mortality will fall.
The analysis also assumes people will adapt to changing temperatures over time, including through greater use of air conditioning and other behavioral or technological adjustments.
That assumption accounts for much of the projected mortality reduction. Without adaptation, CBO estimated that approximately 360,000 deaths would be avoided through 2075 rather than about 2.5 million.
The difference illustrates the substantial role adaptation plays in the agency’s model.
CBO examined intermediate and higher warming scenarios, including SSP2-4.5 and SSP3-7.0. The analysis did not rely on the more extreme RCP8.5 pathway that has been the subject of debate among researchers over whether it represents a likely future emissions trajectory.
Regional differences are evident in CBO’s estimates for Boston and Dallas.
In Boston, an 85-degree day is projected to produce 19 additional emergency department visits and six additional deaths per 100,000 Medicare enrollees. A 25-degree day, by comparison, produces little measurable change in those outcomes.
Dallas shows nearly the reverse relationship.
An 85-degree day there produces little change, according to the analysis, while a 25-degree day is associated with approximately six additional emergency department visits and seven additional deaths per 100,000 Medicare beneficiaries.
The contrast reflects the degree to which populations adapt to their local climates. Residents in places where high temperatures are common are generally better prepared for heat, while unusually cold temperatures can create greater health risks. In cooler regions, unusually hot days can produce larger effects.
CBO projects that emergency department visits related to temperature will nevertheless increase overall.
The agency estimates approximately 18 million additional emergency department visits during the 2030-2075 period even as deaths decline.
Despite that increase in patient volume, Medicare spending on temperature-related emergency care is projected to fall by approximately $55 billion.
The reason is the difference in the cost of the visits being added and those being avoided.
Cold-weather emergency department visits tend to be more expensive, according to the analysis. As warming reduces the number of those costly episodes, the savings are projected to outweigh additional spending associated with a larger number of less-expensive visits occurring during moderate or hot weather.
The result is a projected increase in total emergency department use paired with lower overall spending.
CBO also cautioned that adaptation is not cost-free.
Measures that could reduce the health effects of rising temperatures include expanded air conditioning use and public health campaigns, but the analysis did not estimate the expense of those adaptations. The agency also limited its analysis to the direct effects of temperature and did not attempt to calculate other possible health, economic or environmental consequences associated with climate change.
The projected reduction in mortality among Medicare recipients is consistent with research showing that cold exposure currently accounts for substantially more deaths worldwide than heat.
Separate research cited alongside the CBO findings estimates that heat contributes to roughly 600,000 deaths globally each year, compared with approximately 4.5 million associated with cold.
A 2025 Yale University study also found that vulnerability differs by demographic group and temperature exposure. Older adults, women and people who were widowed or divorced were found to be particularly vulnerable to cold, while younger and single people showed greater vulnerability to heat.
Cold temperatures can contribute to cardiovascular, respiratory and metabolic deaths, while extreme heat has been associated with circulatory problems and deaths involving injuries.
Those differences are particularly relevant to CBO’s analysis because Medicare primarily serves older Americans, a population that can be especially vulnerable to cold exposure.
The findings therefore do not suggest that heat carries no health risk. Rather, CBO’s projections indicate that, among Medicare beneficiaries and under the temperature scenarios examined, the reduction in mortality from fewer cold days is expected to exceed the increase in deaths associated with additional heat.
The role assigned to adaptation is also central to that result. CBO’s projection falls from roughly 2.5 million avoided deaths to approximately 360,000 when adaptation is removed from the model.
The agency’s analysis consequently presents a more complicated relationship between climate and public health than one based solely on rising temperatures. Temperature-related mortality depends not only on how warm or cold conditions become, but also on geography, existing climate patterns, population characteristics and the extent to which people adjust to changing conditions.
CBO did not compare the effectiveness or cost of adaptation with broader federal climate policies, nor did it estimate the full range of possible consequences from climate change. Its findings were limited to temperature-related health outcomes and spending among the Medicare population through 2075.
Comments